Stroke Severity Score based on Six Signs and Symptoms The 6S Score: A Simple Tool for Assessing Stroke Severity and In-hospital Mortality.
10.5853/jos.2014.16.3.178
- Author:
Juan Manual RACOSTA
1
;
Federico DI GUGLIELMO
;
Francisco Ricardo KLEIN
;
Patricia Mariana RICCIO
;
Francisco Munoz GIACOMELLI
;
Maria Eugenia GONZALEZ TOLEDO
;
Fatima PAGANI CASSARA
;
Agustina TAMARGO
;
Matias DELFITTO
;
Luciano Alberto SPOSATO
Author Information
1. Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada. lsposato@uwo.ca
- Publication Type:Original Article
- Keywords:
Stroke;
Mortality;
Complications;
Score
- MeSH:
Cohort Studies;
Hospital Mortality*;
Humans;
Mortality;
National Institutes of Health (U.S.);
Prospective Studies;
ROC Curve;
Stroke*
- From:Journal of Stroke
2014;16(3):178-183
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Ascertaining stroke severity and predicting risk of in-hospital mortality is crucial to advise patients and families about medical decisions. We developed and tested the validity of a new stroke score, the 6S Score (Stroke Severity Score based on Six Signs and Symptoms), for quantifying ischemic stroke severity and predicting in-hospital mortality. METHODS: We prospectively assessed 210 consecutive acute ischemic stroke patients. The cohort was further divided into a derivation (n=120) and a validation (n=90) sample. From a total of 10 stroke signs and symptoms, we selected those with likelihood ratio's P<0.005. We tested the validity of the score for predicting in-hospital mortality by using receiver operating characteristic curves. We used a scatterplot and the Spearman's test to evaluate the correlation between the 6S Score and the National Institutes of Health Stroke Scale as a marker of stroke severity. We used principal component and exploratory factor analyses for assessing qualitative aspects of the 6S Score. RESULTS: The C statistic for in-hospital mortality was 0.82 for the 6S Score and 0.86 for the National Institutes of health Stroke Scale, respectively, with no significant differences between each other (P=0.79). The correlation between both scores was strong (Spearman's rho 0.68, P<0.001). The factor analyses showed a good balance between left/right hemispheres and anterior/posterior circulations. CONCLUSIONS: The 6S Score may constitute a tool for easily assessing stroke severity and predicting stroke mortality. Further research is needed for further assessing its external validity.
